Clinics Med-OP Learning Objectives 2012-2013

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Learning Objectives for Adult Medicine Outpatient Rotations

And Recommended Reading Prior to Various Clinics from The Resident’s Guide to Ambulatory Care.







Overall:
  1. Gain concentrated skill sets to improve care in family medicine clinic.
  2. Learn when you can treat a condition on your own in family medicine clinic and when you need to refer.
  3. Gain familiarity with specialty care so you can help support family medicine patients through such care.

Neurology

  1. Demonstrate competence in performance of basic neurological exam
  2. Discuss diagnostic and therapeutic approach to headaches
  3. Describe the risks and benefits of common seizure medications and review what labs need to be monitored for the various seizure medicines
  4. Review basic work up of Multiple Sclerosis
  5. Review common movement disorders such as Parkinson’s disease.
  • Recommended reading: Pages 206-222 of The Resident’s Guide to Ambulatory Care.

Recommended listening:
Headache Update. Audio Digest Family Practice | Volume 58, Issue 15 | April 21, 2010
Play here (below) or download file


Radiology

  1. Perform basic interpretation of chest x-rays and skeletal films

Minor Procedures
  1. 1. Demonstrate competence with simple interrupted skin closure
  2. 2. Demonstrate competence with the removal of simple skin lesions
  3. 3. Name and utilize common surgical tools for minor outpatient procedures
Suggested reading:

Gastroenterology
  1. 1. Discuss diagnostic and therapeutic approach to GERD and peptic ulcer disease
  2. 2. Discuss diagnostic and therapeutic approach to hepatitis C
  3. 3. Discuss diagnostic and therapeutic approach to irritable bowel syndrome
  4. 4. Understand GI tests and what they will and won’t do for you
  5. 5. Learn the relevant components of a GI history
Suggested reading:
Pages 222-240 of The Resident’s Guide to Ambulatory Care.

Internal Medicine
  1. 1. Discuss diagnostic and therapeutic approach to coronary artery disease
  2. 2. Discuss diagnostic and therapeutic approach to congestive heart failure
  3. 3. Discuss diagnostic and therapeutic approach to hypertension
  4. 4. Discuss diagnostic and therapeutic approach to diabetes
  5. 5. Review work-up and management of hypo and hyperthyroidism
Suggested reading:

Treadmill

  1. Competently perform an exercise stress test with stand-by supervision
  2. Accurately interpret the results of a stress test
  3. Discuss indications for treadmill stress test versus other testing options
  4. Improve EKG reading skills
Recommended reading: Pages 121-129, 161-166 of The Resident’s Guide to Ambulatory Care.

Flexible Sigmoidoscopy

  1. Competently perform flex sig with stand-by supervision by the end of third year
  2. Accurately identify abnormal findings during the flex sig procedure
  3. Discuss colon cancer screening in the normal risk vs. high risk patient
Recommended reading: Pages 107-109 of The Resident’s Guide to Ambulatory Care.

Rheumatology

  1. Discuss diagnostic and therapeutic approach to rheumatoid arthritis
  2. Discuss diagnostic and therapeutic approach to systemic lupus
  3. Discuss diagnostic and therapeutic approach to psoriatic arthritis
Recommended reading: Pages 257-273 of The Resident’s Guide to Ambulatory Care.
Recommended listening:
ARTHRITIS
Internal Medicine | Volume 60, Issue 28 | July 28, 2013
http://www.audio-digest.org/pages/htmlos/45328.3.624941541417245348

Urology

  1. Accurately assess the size and texture of the prostate on digital rectal exam
  2. Discuss diagnostic and therapeutic approach to urinary incontinence
  3. Discuss diagnostic and therapeutic approach to management of kidney stones
  4. Discuss diagnostic and therapeutic approach to prostate cancer and benign prostate hypertrophy
  5. Learn the work up for hematuria
  6. Learn the work up for sexual dysfunction
Recommended reading: Pages 274-284 of The Resident’s Guide to Ambulatory Care.

ENT

  1. Discuss diagnostic and therapeutic approach to recurrent otitis media
  2. Discuss diagnostic and therapeutic approach to chronic hoarseness
  3. Discuss diagnostic and therapeutic approach to chronic cough
  4. Discuss diagnostic and therapeutic approach to chronic sinusitis
Recommended reading: Pages 28-33, 250-256 of The Resident’s Guide to Ambulatory Care.

Ophthalmology

  1. Learn to read an ophthalmology clinic note
  2. Learn how to accurately assess ocular pressure with hand held pressure gauge
  3. Observe a basic diabetic retinal exam
  4. Review differential diagnosis of the red eye
  5. Review ophthalmologic emergencies
Recommended reading: Pages 246-249 of The Resident’s Guide to Ambulatory Care.

Pain and Wellness Clinic

  1. Become familiar with group visit model
  2. Observe psychologist interaction with group with regard to chronic pain management
Recommended reading: Pages 359-361 of The Resident’s Guide to Ambulatory Care.

Positive Health Clinic

  1. Describe the current guidelines as to when to start antiviral therapy
  2. Describe current guidelines regarding when to start and stop opportunistic infection prophylaxis
  3. Describe two preferred regimens for initial antiviral therapy
  4. Describe an initial workup for a newly diagnosed HIV positive patient
  5. Able to recognize thrush and differentiate it from hairy leukoplakia
Recommended reading:
-Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents:
http://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-arv-guidelines/0

Recommended listening:
HUMAN IMMUNODEFICIENCY VIRUS/HEPATITIS C
Internal Medicine | Volume 60, Issue 24 | June 28, 2013
http://www.audio-digest.org/pages/htmlos/45328.10.745781236617245348

Surgery

  1. Recognize normal and problematic healing of post-op wounds
  2. Learn pre-op assessment to determine if surgery will be beneficial
  3. Learn the pre-operative work-up of breast masses, thyroid nodules, and gall bladder disease
  4. Review diabetic wound care
Recommended reading: Pages 347-358 of The Resident’s Guide to Ambulatory Care.


Breast Health Clinic

  1. Show competence in performing a clinical breast exam
  2. Show competence in performing a core biopsy of a breast lump and fine needle aspirations of breast cysts
  3. Discuss diagnostic and therapeutic approach to managing breast lumps
  4. Understand mammogram and ultrasound reports and learn some basic concepts of reading mammograms
Recommended reading: Pages 98-99 of The Resident’s Guide to Ambulatory Care.

Hematology-Oncology
  1. 1. Discuss post treatment management of common malignancies (e.g. breast cancer, lung cancer, colon cancer, prostate cancer)
  2. 2. Discuss the common side effects of common chemotherapeutic agents and radiation therapy
  3. 3. Discuss presentation of common malignancies
Suggested reading:

Chronic Renal Disease
  1. 1. Discuss work-up and differential for chronic kidney disease including diabetic and hypertensive renal disease
  2. 2. Discuss indications for ace inhibitors
  3. 3. Discuss the utility of ultrasound in the context of chronic renal disease
Suggested reading:

Pulmonary Clinic

  1. Show competence in basic interpretation of chest x-rays and CT scans
  2. Discuss diagnostic and therapeutic approach to severe persistent asthma
  3. Discuss diagnostic and therapeutic approach to interstitial lung disease/bronchiectasis
  4. Discuss management of obstructive lung disease, and discuss when to order O2, steroids, antibiotics, pulmonary rehab
Recommended reading: Pages 167-188 of The Resident’s Guide to Ambulatory Care.

Musculoskeletal Clinic

  1. Discuss diagnostic and therapeutic approach to non-operative musculoskeletal injuries
  2. Learn basic joint injection techniques
  3. Learn preventive treatment for overuse injuries
Recommended reading: Pages 299-324 of The Resident’s Guide to Ambulatory Care.

High Risk Preoperative Clinic
  1. 1. Learn how to accurately assess a patient’s surgical risk
  2. 2. Discuss indications for cardiac and sleep apnea testing in the preoperative setting
  3. 3. Learn to take and document an appropriate preoperative history and physical
  4. 4. Learn the importance of functional capacity in the preoperative assessment
Suggested reading:

Allergy clinic

  1. Learn when to order allergy testing
  2. Review when allergy injections are appropriate
  3. Review basic treatment of allergic conditions
Recommended reading: Pages 250-253 of The Resident’s Guide to Ambulatory Care.

Cardiology

  1. Discuss diagnostic and therapeutic approach to coronary artery disease
  2. Discuss diagnostic and therapeutic approach to congestive heart failure
  3. Discuss indications for placement of pacemakers and implantable cardioverter defibrillators (AICDs)
  4. Review indications for cardiac catheterization
Recommended reading: Pages 121-129, 146-162 of The Resident’s Guide to Ambulatory Care.

This page has been edited 8 times. The last modification was made by - jcc240 jcc240 on Jun 19, 2014 5:19 pm